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Background Diagnosis of cutaneous leishmaniasis (CL) usually relies on invasive samples, but it is unclear whether more patient-friendly tools are good alternatives for diverse lesions when used with polymerase chain reaction (PCR). Methods Patients with suspected CL were enrolled consecutively in a prospective diagnostic accuracy study. We compared dental broach, tape disc, and microbiopsy samples with PCR as index tests, using PCR with skin slit samples as reference test. Subsequently, we constructed a composite reference test including microscopy, the 3 index tests and skin slit PCR, and we compared these same tests with the composite reference test. We assessed diagnostic accuracy parameters with 95% confidence intervals for all comparisons. Results Among 344 included patients, 282 (82.0%) had CL diagnosed, and 62 (18.0%) CL absence, by skin slit PCR. The sensitivity and specificity by PCR were 89.0% (95% confidence interval, 84.8%–92.1%) and 58.1% (45.7%–69.5%), respectively, for dental broach, 96.1% (93.2%–97.8%) and 27.4% (17.9%–39.6%) for tape disc, and 74.8% (66.3%–81.7%) and 72.7% (51.8%–86.8%) for microbiopsy. Several reference test–negative patients were consistently positive with the index tests. Using the composite reference test, dental broach, and skin slit had similar diagnostic performance. Discussion Dental broach seems a less invasive but similarly accurate alternative to skin slit for diagnosing CL when using PCR. Tape discs lack specificity and seem unsuitable for CL diagnosis without cutoff. Reference tests for CL are problematic, since using a single reference test is likely to miss true cases, while composite reference tests are often biased and impractical as they require multiple tests. [ABSTRACT FROM AUTHOR]

Objective To prospectively monitor Zika viral loads in semen from Belgian travellers with confirmed Zika virus infection, who returned from the Americas during the 2016 Zika virus epidemic. Methods We recruited symptomatic travellers consulting our clinic and we confirmed infection with either reverse- transcriptase (RT) polymerase chain reaction (PCR) assay or virus neutralization test. The participants produced semen samples weekly, either at the clinic or at home. For the initial sample, the laboratory staff did a microscopy analysis if they received the sample within an hour of production. Using RT-PCR, we monitored Zika virus ribonucleic acid (RNA) loads in semen until we obtained two negative results. Findings We detected Zika virus RNA in nine of 15 participants' semen, one of whom was vasectomized. The median time to loss of RNA detection in semen was 83 days after symptom onset (95% confidence interval, CI: 57-108). The longest duration of viral shedding in semen before obtaining the first negative RT-PCR result was 144 days after symptom onset. All of the 11 participants, for whom we microscopically analysed their semen, had presence of leukocytes, 10 showed haematospermia and six showed oligospermia. These abnormalities occurred irrespective of Zika virus detection in semen. Conclusion The majority of men in our study had detectable Zika virus RNA in their semen. We recommend that semen from Zika virus-infected men should be analysed with RT-PCR and that health professionals should advise infected men, even if they are vasectomized, about current recommendations for prevention of sexual transmission of the virus. Objectif Assurer un suivi prospectif des charges virales du virus Zika dans le sperme de voyageurs belges dont l'infection a virus Zika a ete confirmee et qui sont rentres du continent americain lors de l'epidemie du virus Zika de 2016. Methodes Nous avons recrute des voyageurs symptomatiques qui se sont rendus dans notre centre de consultation et avons confirme l'Infection a l'aide d'un test base sur l'amplification en chaine par polymerase apres transcription inverse (RT-PCR) ou d'un test de neutralisation du virus. Les participants ont produit un echantillon de sperme par semaine, chez eux ou dans le centre. Pour le premier echantillon, le personnel de laboratoire a procede a une analyse au microscope si l'echantillon etait fourni dans l'heure de production. A l'aide d'une RT-PCR, nous avons suivi les charges d'acide ribonucleique (ARN) du virus Zika dans le sperme jusqu'a l'obtention de deux resultats negatifs. Resultats Nous avons detecte l'ARN du virus Zika dans le sperme de 9 des 15 participants, l'un d'entre eux ayant subi une vasectomie. Le delai median pour que l'ARN ne soit plus detecte dans lesperme etait de 83 jours apres l'apparition de symptomes (intervalle de confiance, IC, a 95%: 57-108). La plus longue duree d'excretion virale dans le sperme avant l'obtention du premier resultat negatif de la RT-PCR etait de 144 jours apres l'apparition de symptomes. La presence de leucocytes a ete detectee chez les 11 participants dont nous avons analyse le sperme au microscope; dix d'entre eux souffraient d'hematospermie et six d'oligospermie. Ces anomalies peuvent survenir independamment de la presence du virus Zika dans le sperme. Conclusion Nous avons detecte l'ARN du virus Zika dans le sperme de la majorite des hommes de notre etude. Nous recommandons que le sperme des hommes infectes par le virus Zika soit analyse a l'aide d'une RT-PCR et que les professionnels de sante communiquent les recommandations actuelles concernant la prevention de la transmission du virus par voie sexuelle aux hommes infectes, y compris ceux ayant subi une vasectomie. Objetivo Supervisar de forma prospectiva las cargas viricas del Zika en el semen de viajeros belgas con una infeccion confirmada del virus del Zika, que regresaban del continente americano durante la epidemia del virus del Zika de 2016. Metodos Recluiamos a viajeros sintomaticos que consultaban nuestra clinica y confirmamos la infeccion con las pruebas de reaccion en cadena de la polimerasa de transcriptasa inversa (RT-PCR) o con la prueba de neutralizacion del virus. Los participantes produjeron muestras de semen de forma semanal, en la clinica o en sus casas. Para la muestra inicial, el personal del laboratorio realizaba un analisis de microscopio si recibia las muestras durante la hora de produccion. Usando la RT-PCR, supervisamos las cargas de acido ribonucleico (RNA) del virus del Zika en el semen hasta que obtuvimos dos resultados negativos. Resultados Detectamos RNA del virus del Zika en el semen de nueve de quince de los participantes, uno de los cuales se habia hecho una vasectomia. El promedio de tiempo hasta la deteccion de perdida de RNA en el semen fue de 83 dias tras el comienzo de los sintomas (intervalo de confianza (IC) del 95%: 57-108). El periodo maximo de eliminacion del virus en el semen antes de obtener el primer resultado negativo de la RT-PCR fue de 144diastrasel comienzo de los sintomas. Los once participantes cuyo semen se analizo con el microscopio presentaron leucocitos, diez de ellos mostraron hematospermia y seis oligospermia. Estas anomalias se produjeron independientemente de la deteccion del virus del Zika en el semen. Conclusion La mayoria de los hombres del estudio tenian RNA del virus del Zika detectable en el semen. Se recomienda que el semen de los hombres Infectados por el virus del Zika se analice con RT-PCR y que los profesionales de la salud aconsejen a los hombres infectados, incluso si se han hecho la vasectomia, sobre las recomendaciones actuales para la prevencion de la transmision sexual del virus., Introduction Zika virus infection in humans may result in a mild disease characterized by rash, fever, arthralgia and conjunctivitis. (1,2) However, since its introduction in the Americas in 2015, the [...]

Cerulenin, a natural fatty acid synthase (FAS) inhibitor, and its synthetic analog C75 are hypothesized to alter the metabolism of neurons in the hypothalamus that regulate ingestive behavior to cause a profound decrease of food intake and an increase in metabolic rate, leading to body weight loss. The bulk of data exclusively originates from mammals (rodents); however, such effects are currently lacking in nonmammalian species. We have, therefore, addressed this issue in broiler chickens because this species is selected for high growth rate and high food intake and is prone to obesity. First, we demonstrate that FAS messenger and protein are expressed in the hypothalamus of chickens. FAS immunoreactivity was detected in a number of brain regions, including the nucleus paraventricularis magnocellularis and the nucleus infundibuli hypothalami, the avian equivalent of the mammalian arcuate nucleus, suggesting that FAS may be involved in the regulation of food intake. Second, we show that hypothalamic FAS gene expression was significantly (P < 0.05) decreased by overnight fasting similar to that in liver, indicating that hypothalamic FAS gene is regulated by energy status in chickens. Finally, to investigate the physiological consequences of in vivo inhibition of fatty acid synthesis on food intake, we administered cerulenin by intravenous injections (15 mg/kg) to 2-wk-old broiler chickens. Cerulenin administration significantly reduced food intake by 23 to 34% (P < 0.05 to P < 0.0001) and downregulated FAS and melanocortin receptors 1,4, and 5 gene expression (P < 0.05). However, the known orexigenic (neuropeptide Y, agouti gene-related peptide, orexin, and orexin receptor) and anorexigenic (pro-opiomelanocortin and corticotropin-releasing hormone) neuropeptide mRNA levels remained unchanged after cerulenin treatment. These results suggest that the catabolic effect of cerulenin in chickens may be mediated through the melanocortin system rather than the other neuropeptides known to be involved in food intake regulation. genotype; fasting; hormones; metabolites